AFFIDAVIT

I, _____________________________________________, Filipino citizen, _______ years old

single/married and residing at ____________________________________________, after having been
duly sworn in accordance with the law, hereby depose and state that:

1. I am joining the 2013 Metrobank Art & Design Excellence National Competition, and in connection
therewith,
I
am
submitting
as
my
official
entry,
the
painting
entitled
________________________________________________ hereinafter called the ENTRY,

2. The ENTRY is my original and exclusive creation, being the result of my talent and labor alone, and
has not been copied from nor is similar to any previous or existing work (painting, sculpture, sketch,
photograph, etc.) in terms of composition or otherwise if rendered in a different style, medium or color
scheme;

3. The decision of the Board of Judges as to whether my ENTRY is original or not shall be final and I
bind myself to abide by said decision;

4. I began work on the above-state ENTRY on ________________ and completed and readied the
same for competition on _________________________;

5. I have not had any previous one-man / solo exhibit.

6. In case I fail to claim my ENTRY on the dates specified in the rules, then I agree that it shall
automatically become the property of the Metrobank Foundation, Inc. (The Foundation).

7. I have read and I will abide by the rules, regulations and requirements governing the abovementioned competition and, in this regard, I hereby exempt, discharge, release and free Metropolitan
Bank and Trust Company (Metrobank) and the Foundation, their director/trustees, officers and staff from
any claim or liability arising from any loss or damage which my ENTRY may suffer while being
transported, or while in the custody of the Foundation or the Metrobank; and

8. I am executing this affidavit to attest to the truth, veracity and validity of all the foregoing and to certify,
under oath, the originality, authenticity and ownership of my above-mentioned ENTRY, under pain of
perjury.
FURTHER, AFFIANT SAYETH NAUGHT
____________________________
AFFIANT
REPUBLIC OF THE PHILIPPINES)
) S.S.

SUBSCRIBE AND SWORN TO before me this _______ day of ___________, 20______, in

_____________ affiant exhibiting his/her Community Tax Certificate No._____________ issued at
_________________________ on ________________________, 20_____